Objectives: This study aimed to determine the relationship between glycaemic control and carotid atherosclerotic disease among patients with acute ischaemic stroke (AIS). Methods: This retrospective cross-sectional study took place in the Neurology Department of King Fahad Hospital of University, Khobar, Saudi Arabia, from April to October 2017. Data were collected from the medical records of 244 patients with a diagnosis of AIS confirmed by computed tomography. Doppler ultrasounds of the carotid artery were performed to determine the presence of increased carotid intima media thickness (CIMT) and plaques. Results: Significantly higher mean glycated haemoglobin (HbA1c) levels were noted in cases with high CIMT values (P = 0.002), but not in cases with carotid plaques (P = 0.360). In addition, there was a significant association between diabetes mellitus (DM) and high CIMT (P = 0.045), but not with carotid plaques (P = 0.075). Finally, while dyslipidaemia and age were independently correlated with high CIMT values (P = 0.034 and <0.001, respectively) and carotid plaques (P <0.001 each), no independent relationships were noted in terms of gender and other risk factors like DM, hypertension and smoking (P >0.050 each). Conclusion: High HbA1c levels were associated with high CIMT values, but not with carotid plaques. Therefore, HbA1c levels may be useful as an indirect marker of the initial stages of carotid artery atherosclerosis.
Neurosciences (Riyadh, Saudi Arabia) [Neurosciences (Riyadh)] 2018 Jul; Vol. 23 (3), pp. 185-193.
Anticonvulsants administration dosage, Anticonvulsants adverse effects, Disease Management, Epilepsy drug therapy, Epilepsy psychology, Female, Humans, Pregnancy, Pregnancy Complications drug therapy, Saudi Arabia, Anticonvulsants therapeutic use, Epilepsy diagnosis, and Pregnancy Complications diagnosis
In the context of local culture and misconceptions regarding epilepsy, Saudi practitioners need a careful management plan for women with epilepsy that satisfies all the patients` needs and ensures their spouses` understanding. Such a management strategy needs to incorporate careful selection and monitoring of anti-epileptic drugs and regular counseling of patients. Female epileptic patients in the reproductive age group, no matter whether they are pregnant or not, should be managed by safest drugs from the earliest with folic acid supplementation along with adequate pre-marriage/conception counseling. All antiepileptic drugs are potentially teratogenic. However, valproic acid, phenytoin, phenobarbitone, and topiramate are least favored for use. Monotherapy is preferred over polytherapy, and the least possible dose should be used. During pregnancy, many epileptic women may need monthly drug level monitoring and dose readjustments. Normal vaginal delivery is safe in epileptic women. Post-partum follow-up with anti-epileptic drug titration may be required.
Shahid R, Nazish S, Zafar A, Aljafaari D, Alabdali M, Ishaque N, Alzahrani BA, and Alkhamis FA
Neurosciences (Riyadh, Saudi Arabia) [Neurosciences (Riyadh)] 2018 Jul; Vol. 23 (3), pp. 223-226.
Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Saudi Arabia, Epilepsy epidemiology, and Tertiary Care Centers statistics numerical data
Objective: To identify the types of seizures and describe the clinical features, EEG and radiological findings among patients with epilepsy. Methods: In this retrospective epidemiological study, we analyzed the medical records of the patients with the diagnosis of epilepsy during the study period (January 1st 2016- December 2016) RESULTS: The study included 184 patients, 91 (49.5%) were males and 93 (50.5%) females. Age ranged between 12 and 85 years (mean 35.4+/-19.5 SD years). Most of the patients 150 (82%) had Generalized tonic clonic seizures followed by focal onset in 27 (14%) of the patients. Main EEG abnormality was focal to bilateral was recorded in 53 (41%), idiopathic/ cryptogenic epilepsy was diagnosed in 61% of the patients. The most common abnormalities on brain imaging were temporal/hippocampal atrophy/stroke. The most common cause of symptomatic epilepsy was stroke found in 20(11%) followed by post infectious epilepsy and head trauma. Conclusion: Seizure types, EEG characteristics and etiologies of symptomatic epilepsy in our cohort of patients are in accordance with the current literature. Slight discrepancy observed in gender distribution and etiologies for symptomatic epilepsy compared with other studies from Saudi Arabia need to be studied further by prospective and population base studies.
AboAlSamh DK, Abulaban AA, Khatri IA, and Al-Khathaami AM
Neurosciences (Riyadh, Saudi Arabia) [Neurosciences (Riyadh)] 2017 Oct; Vol. 22 (4), pp. 320-324.
Adult, Aged, Cohort Studies, Female, Glomerular Filtration Rate physiology, Humans, Kidney Diseases diagnosis, Male, Middle Aged, Odds Ratio, Predictive Value of Tests, Risk Factors, Saudi Arabia epidemiology, Kidney Diseases etiology, Stroke complications, and Stroke diagnosis
Objective: To explore if renal dysfunction in terms of estimated glomerular filtration rate (eGFR) can be considered a risk factor for stroke outcomes. Methods: The study population consisted of adults diagnosed with acute stroke admitted to the King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia between 2012 and 2015. Data was collected by chart review. The Modification of Diet in Renal Disease equation was used to estimate GFR. Patients were classified into 2 eGFR categories: eGFR more than 60 (normal) and eGFR less than or equal 60 (low). Results: A total of 727 patients were studied of whom 596 (82%) had normal eGFR and 131 (18%) had low eGFR. There were more males (68.5%). Ischemic strokes were more prevalent (87.2%). Urinary tract infections were more likely to occur in the low eGFR group (OR=2.047, 95% CI=1.024 - 4.093). They were also significantly more likely to die during admission (OR=3.772, 95% CI=1.609-8.844). There was a statistically significant degree of disability reflected by higher mRS (p=0.010) as well as higher post-stroke National Institute of Health Stroke Score scores in the low eGFR group (p=0.011). Conclusion: Estimated glomerular filtration rate is a possible predictor of stroke severity, disability and mortality.